Miss. Code. tit. 18, pt. 6, ch. 1, 18-6-1-D, 18-6-1-D-XII, app 18-6-1-D-XII-B
Contract for Foster Care
THIS AGREEMENT is entered into this day, between (a) ________________________ and (a) ___________________ as parents or legal guardian of (b) ________________________, and the (c) ____________________ County Department of Human Services.
WITNESSETH:
Because I/we, (d) ______________________, as parent of the above named child, are presently in need of a proper home situation and guidance of my/our child, we agree to enter into this agreement with the above named County Department of Human Services for voluntary foster placement with said County Department of Human Services exceed 180 days.
I.
(1) Parent agrees to place said child, into the temporary full care and custody of said County Department of Human Services for the purpose of placing said child into a foster home or other appropriate placement.
(2) That said County Department of Human Services has the immediate right to place said child in a suitable environment as deemed necessary and proper for the wellbeing of said child, including the authorization of medical and surgical procedures upon the advice of a licensed physician. Parents further release and discharge the Department of Human Services, its employees, agents and others acting on its behalf from any and all claims, demands, liability and damages of whatsoever nature, arising out of this foster placement.
(3) Parents agree to pay (e) _______________ dollars per (f) ________________ as support, to help cover the expense of this placement.
(4) Parents agree to cooperate with the said County Department of Human Services to develop a schedule of visits and contracts with said child working toward the return of said child within a specified time period, not to exceed 180 days.
II.
(1) The above named County Department of Human Services agrees to accept temporary full care and custody of said child, and place said child in a suitable environment.
(2) The above named County Department of Human Services agrees to pay a board payment to the people/person designated as the foster parent of said child, and to supervise the foster home in accordance with the approved standards of foster care as established by the State Department of Human Services.
(3) The above named County Department of Human Services agrees to cooperate with the natural parents in establishing a schedule of visits, and further to develop a plan, including the provision of available support services, leading towards the return of said child within a specified period not to exceed 180 days.
III.
Both parties acknowledge and expressly agree to the following:
1. This contract does not award full permanent care and custody of said minor, and this contract does not award full permanent care and custody of said minor, and this contract does not in any way amount to a release of said child for adoption, or act as a waiver of any parental rights, provided that said parties act in good faith to fulfill the intent of this agreement.
2. The failure of the parents to provide the monthly child support payments without proper cause and failure to cooperate with the above named County Department of Human Services for the return of said child, or the failure to maintain contact with said child either personally, by phone or by mail, shall constitute sufficient cause for said County Department of Human Services to seek court ordered custody on the grounds of neglect by abandonment and/or to begin the process of Termination of Parental Rights, and the placement of said child for adoption under the laws of the State of Mississippi.
3. It is further understood that parents are entitled and encouraged to maintain contact with their child and the Department of Human Services shall make every effort to arrange visits at the mutual convenience of the Department of Human Services and the parents, unless barred from doing so by Court Order, or upon the written advice and counsel of a qualified psychological source.
4. It is understood and agreed that said parents may regain the custody and control of said child, upon two weeks' notice in writing to the (g) __________________________ County Department of Human Services.
5. This Contract will expire 180 days from the date of its signing.
WITNESS OUR SIGNATURES:
_______________________________ __________________________________
Father(signature or mark) Date Area Social Work Supervisor Date
_______________________________ __________________________________
Mother (signature or mark) Date Witness Date
__________________________________
Witness Date
Miss. Code. tit. 18, pt. 6, ch. 1, 18-6-1-D, 18-6-1-D-XII, app 18-6-1-D-XII-B